Balding Blog

I wrote about this here: https://baldingblog.com/selecting-hair-transplant-doctor/

This is a global approach to selecting any doctor for cosmetic work anywhere. We have monthly open house events for prospective patients to (1) meet many patients one-on-one and judge the quality of the work for themselves, (2) see a surgery live actually on the day of the Open House and (3) get a free consultation to get a Master Plan built for your hair covering short and long term hair loss possibilities. Few doctors will do this because dissatisfied patients come and can ruin such an event as happened a number of years ago where former patients actually picketed the doctor’s office. Your doctor should be proud of his/her patients and willing to bring patients for meetings to educate you. I also started doing this in 1993 at medical meeting where I brought my patients to teach doctors what a good hair transplant should look like. After many years, the ISHRS (International society) had established patient ‘live viewing’ sessions at every annual meeting. What is good for the doctor, should be good for you, the patient.

The only way to determine DUPA is with a video microscope showing the details of the donor area. I always insist that the area I look at is cut short (a couple of mm long) so that I can count the miniaturized hairs. A count in excess of 20% of miniaturized hairs reflects DUPA as I defined it in my published article. Yes, finasteride sometimes works to reverse it (less that 50% of the time).

Hi Doctor, you say that one lose on average 100 hairs each day. On what basis you say that? is it based on a scientific research and finding or just your own guess based on average number of hairs on someone’s head and the percentage of hair in telogen phase and length of the latter. If any of these parameters is in fact different, which is likely to be, then your assumption will not be accurate or correct. Thank you for all

The 100 hair loss a day has been widely published and accepted as the normal shedding of hair. Also note that it is not actually 100 hairs a day everyday, but “UP TO” 100 hairs a day.

If you take in to account that our hairs are also growing in cycles or telogen (resting), anagen (growth), catagen (transition) phases 100 hair loss a day out of 100,000 hairs is 0.1% of your total hair count. Also take into account while you are losing 100 hairs there are likely another 100 hairs that are starting their anagen (growth).

Anagen phase in measured in years, telogen phase in measured in months so more hair is actually in the growth phase in a normal cycle.

There are always exceptions to the rule, and not everyone is the same.

My boyfriend is balding and does not believe in hair transplant procedures. I’m looking for a top doctor/establishment in North America to have a consultation and hopefully change his mind about undergoing the procedure. Was wondering if anyone has any recommendations since I’m not sure where to start/go looking.

There are websites that rate hair transplant doctors including Yelp and realself.com. I always tell patients to check out the doctor’s experience and rule out doctors who sell their services through salesmen or saleswomen. For example, you can look me up here (resume and cv): http://newhair.com/doctors/rassman/ and you can check out my references on those websites. If you don’t want to travel, then check out the doctors in your area and see how they present themselves.

I personally trained Dr. Diep and he along with other good doctors are capable of performing hair transplants (even FUE) on mix races without difficulty because they are well trained. I have been doing FUE on mix races for longer than any doctor in the world as I pioneered the FUE.

Best FUE doctors for mixed race hair? from tressless

If you take a photo of your cut hairs like this with either a hand video microscope (available on Amazon) or a good camera with a zoom in feature, you will see the follicular groups. The average Caucasian density averages 2.1 hairs per Follicular Group so if you count the number of groups and the number of hairs, you can know for certainty what your donor density is. In these pictures, the circles in C and D have higher than normal donor densities as the average number of hair in each Follicular Unit averages significantly above 2.1 hairs per Follicular Unit. That means that the person who has the higher donor density has more hair to transplant and if they want to do FUE, can do certainly more grafts based upon the chart here: https://newhair.com/resources/#tab-id-4

Dear Dr.,

If you can’t accurately measure the growth rate of your hair transplants (as posted in a previous blog post), how do you determine if a transplant was successful considering that no quantitative data is available (i.e. 95% growth)…?…

Also, since you’ve been doing this so long, what is your opinion on whether people are too vain? You must see lots of interesting information regarding this since you are in a unique position as a hair transplant surgeon.

Success is determined by your ability to achieve your goals provided that you have had realistic expectations of it. A good doctor will tell you if it meets his/her expectations. I have had patients who felt that they had their expectations met and I did not, so in those very, very few patients I usually just do another hair transplant at my cost.

We are all vain, but we do not like to admit it. I can fill hundreds of pages of stories on vanity, but I’ll save them for another time. I don’t believe people are too vain, but some people see vanity as a problem, and that is where I disagree. There is nothing wrong with wanting to look as good as you feel (or hope to feel).

Doctor Rassman.

How are you. I love the website. My question surrounds the importance of finding an ethical doctor who is not just about the money. As a layman (like myself) I am not that experienced in hair transplants and what to do, I rely solely on the doctor. The only experience or knowledge I have is by coming on your website and reading things about hair loss on the internet.

So, How would I know who is a good doctor, what is the proper number of grafts I should receive, and if the doctor places grafts into my head is he placing them in the right spot so I won’t have shock loss etc etc.

I would mostly go with what the doctor says because I am putting my trust in him, unless he says something totally absurd then I know to back off.

I can read all day on the internet about hair loss and what to do, but how do we truly know whatever the doctor says is in a patients best interest and isn’t about the money, because every patient and situation is different.

Thanks

I put together a guide for patients, where I detailed the approach I would take if I selected any doctor for any reason. If you go for a consultation and end up meeting a salesman, then I would generally suggest that selling is the doctor’s priority. If you come to my open house events, you can meet many patients face-to-face and look at the quality you will get (as what you see is what you get). Photographs can be misleading and show what the photographer wants the viewer to see. Photos of a doctor’s work should be augmented by meeting real patients in person.

We all have instincts which we must rely on, so use your instincts to know if you met the greatest bullsh*tter of all time. Some of the worst doctors in this business have a style like a con man and the looks of Brad Pitt. Can you tell a con man when you meet one? The recommendation of the doctor, with regard to the work you will need, should match other opinions you should get from other doctors. If they do not match up, then you need to challenge both recommendations and see if they make sense.

Fortunately, I have written many books and articles which cover most everything that you need to know (see our Medical Publications, where everything is documented). Lastly, ask yourself if you like the doctor personally, and if you trust him/her to be there when you need him/her. I carry my cell phone 24/7 and every patient has 24/7 access to me. That is my way of telling the patient that I will always be there if he needs me at any time. Over the years, I have helped men who had heart problems, having nothing to do with the hair business, so that is my way of saying “trust me”.